Vital role of midwives in hard-to-reach areas

Midwives play a critical role in ensuring the well-being of mothers and children in Uganda, particularly in hard-to-reach areas. Despite facing numerous challenges, these dedicated healthcare professionals are tirelessly working to improve maternal and child health outcomes.

 Recognizing and appreciating the invaluable services provided by midwives in remote regions is crucial for enhancing healthcare delivery, strengthening education, and ultimately building healthier communities.

One of the primary challenges faced by midwives in hard-to-reach areas is the shortage of skilled professionals. Uganda, like many other developing countries, is grappling with an insufficient number of midwives especially in remote regions.  The state of world Midwifery report 2021 by UNFPA established a global shortage of 1.1 million Sexual Reproductive Maternal Newborn Adolescent Health (SRMNAH) workers, the largest shortage (900,000) being midwives. However, by investing in the recruitment, training, and deployment of midwives specifically in these challenging areas, Uganda can bridge this gap and significantly improve maternal and child healthcare. For instance, the “Saving Mothers, Giving Life” initiative implemented in Uganda’s northern region witnessed a notable reduction in maternal and newborn mortality rates by bringing skilled midwives to remote communities.

Recognizing midwives in hard-to-reach areas necessitates an emphasis on strengthening their education and training.  By establishing midwifery schools and programs within or close to remote communities, Uganda can ensure that aspiring midwives have access to education without having to relocate to urban areas. The example of the Kibaale Midwifery School, which provides training and education to students from underserved communities, showcases the transformative impact of localized educational initiatives. Midwives working in hard-to-reach areas often face challenging work conditions, including long hours, limited resources and inadequate infrastructure.

Improving these conditions is vital to retain and attract midwives to underserved regions. Provision of essential resources such as medical equipment, safe working environments and reliable transportation can significantly enhance the morale and efficiency of midwives. The establishment of midwife-led birthing centers in remote regions of Uganda, such as the Butogota Health Center II, has not only improved work conditions but also increased access to quality maternal and child healthcare. Midwives in hard-to-reach areas have lots of untold stories, therefore to recognize and appreciate them, it is essential to foster collaboration and support from both the community and institutions. Strengthening partnerships between midwives and community members can improve trust, encourage utilization of services, and lead to better health outcomes. Additionally, institutional support through policies, funding, and recognition programs can motivate midwives and promote their well-being. The example of the Village Health Teams (VHTs) in Uganda, consisting of community health workers who collaborate with midwives, has shown promising results in reducing maternal and child mortality rates in remote areas. Recognizing midwives in hard-to-reach areas also involves promoting collaborative care among various healthcare professionals. By fostering teamwork and effective communication between midwives, doctors, nurses and other stakeholders, Uganda can ensure comprehensive and seamless healthcare delivery.

The integration of midwifery services within the broader healthcare system and the development of referral networks are crucial steps towards achieving this goal. A shining example is the partnership between midwives, doctors and other healthcare professionals on the Lango Maternity and Neonatal systems coordination platform, where collaboration has improved access to skilled care during childbirth and saving lives of many mothers and their babies.

In conclusion, recognizing and appreciating the invaluable contribution of midwives in hard-to-reach areas of Uganda is essential for improving maternal and child health outcomes and our country can significantly enhance healthcare delivery in remote regions. Investing in midwives leads to healthier communities, happier mothers, and brighter futures for all. It is high time we recognize these unsung heroes and provide them with the appreciation they deserve.

Ms Hadijah Nakatudde, executive midwife leader, international confederation of midwives, secretary  nmau,eastern region.